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January 4, 1941


Author Affiliations

From the Haynes Memorial, Massachusetts Memorial Hospitals, and the Department of Pediatrics, Harvard Medical School.

JAMA. 1941;116(1):36-38. doi:10.1001/jama.1941.02820010038009

During the eruptive phase of scarlet fever the urine rarely shows more than a trace of albumin, a few granular casts and possibly a few leukocytes and red cells. This relatively mild inflammation of the kidneys usually subsides with the rash and fever and requires no treatment other than that generally applicable to the disease itself. The fact that this initial renal inflammation responds to the early use of scarlet fever antitoxin is evidence of its being due to the direct action of the erythrogenic toxin.1

Glomerulonephritis may occur during the eruptive stage, but the great majority of severe cases take place late in the convalescence2 and often when the initial rash and fever have been so extremely mild3 as to be without any signs of the benign renal disturbance which I have just mentioned.4

It is impossible to consider here the physiologic mechanism of the